BDS 11081 immediate dentures.pdf

BDS11081 Immediate denture Date : 2023 Aims The educational aims of this lecture are: - To detail the indications and benefits of immediate dentures - To explain the process (clinical and lab procedures) to deliver immediate denture - To explain the follow up and ultimate replacement options Obj...

BDS11081 Immediate denture Date : 2023 Aims The educational aims of this lecture are: - To detail the indications and benefits of immediate dentures - To explain the process (clinical and lab procedures) to deliver immediate denture - To explain the follow up and ultimate replacement options Objectives On completion of this lecture, the student should have - An understanding of when immediate dentures are indicated - An understanding of how to prepare and deliver immediate dentures - An understanding that immediate dentures are temporary treatment It is a denture, inserted and placed immediately after extraction of the teeth ▪ The remaining natural teeth act as an excellent pre- extraction record ▪ Preserve patient appearance. ▪ The patients can better tolerate the transition from dentulous to edentulous state promotes better ridge form ▪ The functions of speech and mastication are sustained.  Decrease the physiological trauma to patient.  Provides a guide for the V.D.O.  Less interruption of business and social life  Provides a dressing protect the wound, blood clot from food and tongue action → promotes healing.  No try in for anterior teeth.  Increased treatment time and cost.  Subsequent relining, rebasing or even remake in a short period of time.  Less retention.  Increased post placement adjustments than conventional C.D.  Patients with poor surgical risk e.g. cardiovascular diseases.  Patients with acute infection i.e. need drainage.  Uncooperative, mentally disturbed patients.  Patients with neurological or physiological conditions.  Patient undergone radiation therapy  All remaining posterior teeth except 2 opposing molars or premolars in good occlusion to keep the V.D.O. 1st clinical app. 2nd clinical app. Clinical steps Laboratory steps Diagnosis& Primary imp. Special tray fabrication Secondary imp. Master cast +fabrication of occlusion rims 3rd clinical app. Jaw relation +teeth selection Waxed trial denture base 4th clinical app. posterior try in Processing of the denture. 5th clinical 6th clinical app. app. Extraction& denture insertion& Adjustments& instruction 24 hours post insertion check and adjustments 72 hours and one week post 7th clinical app. insertion check and adjustments+ clinical remounting EXAMINATION AND PRELIMINARY IMPRESSIONS APPOINTMENT ❑ History ❑ Oral examination ❑ Mounted diagnostic casts ❑ Radiographic interpretation 1st clinical app. 2nd clinical app. Clinical steps Laboratory steps Diagnosis& Primary imp. Special tray fabrication Secondary imp. Master cast +fabrication of occlusion rims 3rd clinical app. Jaw relation +teeth selection Waxed trial denture base 4th clinical app. posterior try in Processing of the denture. Extraction& denture 5th clinical app. insertion& Adjustments& instruction 6th clinical app. 24 hours post insertion check and adjustments 72 hours and one week post 7th clinical app. insertion check and adjustments+ clinical remounting 1st clinical app. 2nd clinical app. Clinical steps Laboratory steps Diagnosis& Primary imp. Special tray fabrication Secondary imp. Master cast +fabrication of occlusion rims 3rd clinical app. Jaw relation +teeth selection Waxed trial denture base 4th clinical app. posterior try in Processing of the denture. 5th 6th clinical app. clinical app. Extraction& denture insertion& Adjustments& instruction 24 hours post insertion check and adjustments 72 hours and one week post 7th clinical app. insertion check and adjustments+ clinical remounting Final Impression Single custom tray technique: most commonly used Two-piece tray technique: for very divergent teeth or severe ridge undercuts 1st clinical app. 2nd clinical app. Clinical steps Laboratory steps Diagnosis& Primary imp. Special tray fabrication Secondary imp. Master cast +fabrication of occlusion rims 3rd clinical app. Jaw relation +teeth selection Waxed trial denture base 4th clinical app. posterior try in Processing of the denture. 5th clinical 6th clinical app. app. Extraction& denture insertion& Adjustments& instruction 24 hours post insertion check and adjustments 72 hours and one week post 7th clinical app. insertion check and adjustments+ clinical remounting  Occlusion blocks are constructed.  Centric occluding relation is obtained at proper V.D.O. Clinical steps Laboratory steps 1st clinical app. Diagnosis& Primary imp. Special tray fabrication 2nd clinical app. Secondary imp. 3rd clinical app. Jaw relation +teeth selection Waxed trial denture base 4th clinical app. posterior try in Processing of the denture. 5th clinical 6th clinical app. app. Extraction& denture insertion& Adjustments& instruction 24 hours post insertion check and adjustments 72 hours and one week post 7th clinical app. insertion check and adjustments+ clinical remounting Master cast +fabrication of occlusion rims For the posterior teeth to check:  a) Vertical dimension of occlusion  b) Centric occlusion  c) Even bearing on both sides. 1st clinical app. 2nd clinical app. Clinical steps Laboratory steps Diagnosis& Primary imp. Special tray fabrication Secondary imp. Master cast +fabrication of occlusion rims 3rd clinical app. Jaw relation +teeth selection Waxed trial denture base 4th clinical app. posterior try in Processing of the denture. 5th clinical 6th clinical app. app. Extraction& denture insertion& Adjustments& instruction 24 hours post insertion check and adjustments 72 hours and one week post 7th clinical app. insertion check and adjustments+ clinical remounting Do not remove until tomorrow's appointment  If it comes loose/out put it back in place immediately  Soft/liquid diet for 24 hours  Avoid rinsing  Take analgesic  Expect red saliva  Remove and clean denture  Relieve sore spots  Relieve sore spots  Use PIP  Refine occlusion  Use tissue conditioner to refit as needed  Remove any socket convexities to avoid healing defects  Reline or remake in 6 to 9 months Immediate denture Socketed Simple Extraction With Alveloplasty Flanged Inter-septal Labial Plate  Only indicated in upper arch  Root sockets are made in cast into which the necks of the artificial teeth are fitting: Advantages  Provide natural appearance. Disadvantages  No labial flange → ↓  Presence of labial undercut doesn't complicate insertion.  Position of anterior teeth is exactly reproduced. retention and stability.  Recession of gums → expose neck of teeth. Advantages:  Retention and resistance of denture to Disadvantages  Difficulty in denture anterior posterior movement. insertion if there's labial  Lip support.  Allow freedom in changing the position undercut of anterior teeth.  Might produce lip fullness  Protection of healing sockets  If recession happen → gum margin isn't visible Indications:  Patients with prominent premaxilla with tilted teeth outward.  Patients with shallow sulcus with no room for labial flange. N.B: For both techniques of immediate denture with alveoloplasty, the construction of a transparent acrylic template over a duplicate cast of the reduced one is helpful in detecting areas requiring further modifications before suturing. 1. Surgery starts with the denture and the surgical template. 2. A flap is opened after extraction, and the labial plate is removed in the labial plate alveoplasty, while in the interseptal alveoplasty only the interseptal bone is removed. 3. Excess mucosa is trimmed, and suturing is done. 4. The surgical template is placed several times to make sure enough bone was removed. NEWGIZA UNIVERSITY Students are advised to read details at: • Clinical and laboratory manual of implant overdentures, Hamid R. Shafie. • Prosthodontic treatment of edentulous patients, 13th edition. Zarb, Hobkirk, Eckert and Jacob. (chapter 13) • Textbook of complete dentures, 6th edition. Arthur Orahn, John R. Ivanhoe and Kevin D. Plummer, 2009. (chapter 16) Aims NEWGIZA UNIVERSITY The educational aims of this lecture are: - To detail the indications and benefits of immediate dentures - To explain the process (clinical and lab procedures) to deliver immediate denture - To explain the follow up and ultimate replacement options Objectives On completion of this lecture, the student should have - An understanding of when immediate dentures are indicated - An understanding of how to prepare and deliver immediate dentures - An understanding that immediate dentures are temporary treatment NEWGIZA UNIVERSITY Thank You